Welcome to a new year! Why not make this the year you finally pay closer attention to your body and prevent concerns before they can become problems?
Few health topics evoke more consternation than the Big “C.” Generally speaking, the incidence of cancer increases with age. I was taught in medical school that all of us have several dormant oncogenes, or cancer cells, in us right now. The expression of these cells depends upon a variety of environmental influences. Unfortunately, you can do everything right and still end up being bitten. If you are destined to be one of the unlucky ones, there are things you can do now to help beat the odds.
This is what I tell my patients: if you have a first-degree relative (parent, sibling, or child) or a second degree relative (grandparent, aunt/uncle, or niece/nephew) who has had some type of adult cancer, you should have the recommended test done 10 years earlier than the age when they were first diagnosed. Otherwise, here are my general cancer screening guidelines:
The most common cancer overall. Avoid sunburns and excessive tanning, use sunscreen, and watch for changes. I explain the “ABCDEs of Dermatology” as follows:
Asymmetry—Divide the mole or lesion through the middle. Is it a mirror image on both sides? If not, get it checked.
Border—Is it irregular or smooth? Irregular may signal a problem.
Color—Are there two or more colors in the same lesion, or has it recently changed color? If so, get it checked.
Diameter—Get it checked if it is larger than the end of a pencil eraser.
Elevation—Does it raise off the skin? This may indicate cancer.
Most moles and spots on the skin are just that—moles and spots. But if there is a change or it meets any of the above criteria, ask your doctor about it.
The most common cancer in teenage girls and early adult women. Get a yearly PAP smear and gynecological exam starting at age 21 or the onset of sexual intercourse (whichever comes first). Uterine and ovarian cancer risks increase with age and should be screened at yearly exams.
The most common cancer in teenage boys and younger men. Remember Lance Armstrong? Do a monthly self exam and get a yearly doctor’s exam starting at age 12.
The most common lethal cancer overall; it comes primarily from smoking, but not always. If you have a history of tobacco use, have had long-term exposure to cigarette smoke, or have an unexplained persistent cough, talk to your doctor.
The second most lethal cancer in women. There is a lot of controversy on screening for this one. I recommend monthly self breast exams starting at age 21 (the best time is about a week after your period is over), and yearly exams by your primary care physician, also starting at age 21. Get yearly mammograms starting at age 40.
The second most lethal cancer in men. Get a yearly PSA blood test and doctor exam from age 50 on. (Don’t complain guys, women still have it worse.)
The third most lethal cancer over all. Watch for any blood or changes in bowel habits and get your initial colonoscopy at age 50. We’ll tell you how often you’ll need one after that, depending on the results. These are just the very basics and my own rules. Do your genealogy. Know your family’s health history. Remember, if you have questions, talk to your doctor. Doing nothing doesn’t help anyone—least of all you.
Now let’s get healthy!
Thomas J. Boud, MD, is board certified in family medicine and practices in a very busy primary care medicine clinic in the Salt Lake Valley. He is also a volunteer physician for the Church’s Missionary Medical Department and cares for the health care of many of the local full-time missionaries. He served a mission in Southern Germany and Austria. He is an avid runner, having completed more than 50 full marathons. He is married to a very patient wife and has six beautiful children, two of which are currently serving full-time missions.